HomeMy WebLinkAboutL 11994 P 227 -'' PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
• INSTRUCTIONS: http:H www.orps.state.ny.us or PHONE (518) 473-7222
FOR COUNTY USE ONLY -----
/� r REAL PROPERTY TRANSFER REP
C1. SWIS code I �, >,
1!/1) STATE OF NEW YORK
C2. Date Dead Recorded I / v l l f>�I STATE BOARD OF REAL PROPERTY SERVICES
Month Day- year
- RP - 5217
/ / /-1 )
C3. Book I `�7CC4. Page �/.:/ excnno4
RP-5317 Rev 3/97
PROPERTY INFORMATION
1. Property 1 10765 1 County Route 48 1
Location STREET NUMBER STREET NAME
Southold I197I
CITY OR TOWN VILLAGE ZIP CODE
2.Buyer IPolliO Ruth Trustee of theeRuth Pollin �evnrahlP Trust dated Augrarst 18 1999 1
Name LAST NAME/COMPANY FIRST NAME
LAST NAME/COMPANY FIRST NAME
3.Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address(at bottom of form) 1
Address LAST NAME/COMPANY FIRST NAME
STREET NUMBER AND STREET NAME CITY OR TOWN STATE ZIP CODE
4.Indicate the number of Assessment ❑ (Only if Part of a Parcel)Check as they apply:
Roll parcels transferred on the deed #of Parcels OR X Part of a Parcel 4A Planning Board with Subdivision Authority Exists ❑
S.Deed
4B.Subdivision Approval was Required for Transfer ❑
Property I X ORI 2 , 0 a I , 7 I 4C.Parcel Approved for Subdivision with Map Provided El FRONT FEET DEPTH ACRES
6.Senor I Po12io 1 Joseph 1, 1
Name _AST NAME/COMPANY FIRST NAME
I Pollio I Ruth
LAST NAME/COMPANY FIRST NAME
7.Check the box below which most accurately describes the use of the property at the time of sale: Check the boxes below as they apply:
8.Ownership Type is Condominium ❑
AHOne Family Residential E Agricultural I Community Service 9.New Construction on Vacant Land E]B2 or 3 Family Residential F Commercial 1 Industrial 10A.Property Located within an Agricultural District El
CResidential Vacant Land G Apartment K Public Service 10B.Buyer received a disclosure notice indicating ❑
DNon-Residential Vacant Land H Entertainment/Amusement L Forest that the property is in an Agricultural District
SALE INFORMATION 15.Check one or more of these conditions as applicable to transfer:
11.Sale Contract Date & / 'I /99 1 A Sale Between Relatives or Farmer Relatives
Month Day Year B Sale Between Related Companies or Partners in Business
C One of the Buyers is also a Seller
12.Date of Sale/Transfer I R / / 99 D Buyer or Seller is Government Agency or Lending Institution
Month Day Year E Deed Type not Warranty or Bargain and Sale(Specify Below)
F Sale of Fractional or Less than Fee Interest(Specify Below)
G Significant Change in Property Between Taxable Status and Sale Dates
13.Full Sale Price f�y. 0 0 H Sale of Business is Included in Sale Price
7
(Full Sale Price is the total amount paid for the property including personal property. I ;( Other Unusual Factors Affecting Sale Price ISpeciry Below)
This payment may be in the form of cash,other property or goods,or the assumption of i None
mortgages or other obligations.) Please round to the nearest whole dollar amount.
Gift
14.Indicate the value of personal 1 0 . 0 1
property included in the sale > ; •
ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill Part Of
16.Year of Assessment Roll from 1 9 , 8 i7 Total Assessed Value(of all parcels in transfer) I .5 0 .0 0
which information taken 7
18.Property Class I I 0—1_ 19.School District Name I MAf-f-i fnrk Sr}rnnI
20.Tax Map Identifier(s)/Roll Identifier(s)(If more than four,attach sheet with additional identifieds))
I 1nR_-1-1 .1 I I I
I I I I
CERTIFICATION
I certify that all of the items of information entered on this form are true and correct(to the best of my knowledge and belief)and I understand that the making
of any willful false statement of material fact herein will subject me to the provisions of the penal law relative to the making land firing of false instruments.
BUYER BUYER'S ATTORNEY
Lavelle IJohn H.
BUYER SIGNATURE DATE LAST NAME FIRST NAME
P.uth Pollio, Tuantee
3 1 Copperfikid Lane 519 1 869-6227
STREET NUMBER STREET NAME IAFTER SALE) AREA CODE TELEPHONE NUMBER
Old BrooEville 1 NY 1 11545
CITY OR TOWN STATE ZIP CODE
SELLER CITY/TOWN ASSESSOR
COPY
I
SELLER SIGNATURE DATE
Joseph Pollio